Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Park House James Street Tyldesley Wigan Greater Manchester M29 8JJ one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Simon Hill Date: 2 2 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Park House James Street Tyldesley Wigan Greater Manchester M29 8JJ 01942882344 01942886188 sharon.davies@clsgroup.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : CLS Care Services Limited care home 40 Number of places (if applicable): Under 65 Over 65 10 40 8 dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 The home is registered for a maximum of 40 service users to include:- up to 30 service users in the category of OP (Older People over the age of 65). up to 8 service users in the category of PD(E) (Older People over 65 years with a physical disability). up to 10 service users in the category of DE(E) (Older People over 65 years with dementia) The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. The service should employ suitably qualified and experienced members of staff, in sufficient numbers, to meet the assessed needs of the service users, including those with dementia. Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Park House, part of the CLS group of homes, is situated close to Tyldesleys local amenities and is well served by public transport. Park House is registered to provide personal care for up to 40 residents of either sex over the age of 65, 10 of whom may have dementia. The Home is a single storey building, which is set in well-maintained grounds. All bedrooms are offered as singles; there are no shared rooms at Park House. At the time of this inspection weekly fees ranged from 420.00 to 505.00 pounds per week. Additional charges were for hairdressing, outings, newspapers, toiletries etc. Care Homes for Older People Page 3 of 9 What we found:
We visited the home because we found shortfalls in the way medicines were handled at a recent key inspection. The visit was carried out by a pharmacist inspector. It lasted approximately four and a half hours and involved speaking with the manager, two carers and one resident. We checked a sample of medicines stocks, medicines records and care plans. We gave detailed feedback to the manager at the end of the visit. Overall we found some shortfalls when handling medicines that could affect the health and wellbeing of people that live in the home. We checked a sample of medicines records and stock and found an organised system of stock control that made accounting for medicines simple. New supplies of stock were started at the beginning of each month and when stock was left over it was clearly carried forward. We carried out some random checks of boxed medicines and found that some did not add up correctly, which showed that they had been occasionally missed. Several people had missed their medicine to treat stomach acid at least once and another person missed two of their heart medicines at least twice in the last month. Missing medicines can seriously affect a persons health and wellbeing. We looked at the times medicines were given and found the records did not always state the correct time to take the medicines in relation to food intake. Two different carers both confirmed that some medicines were being given at the wrong time notably some medicines that should be given before food were being given after. Giving medicines at the wrong time can stop them working properly. We saw some good practice in both units of the home as people were not normally woken up to have their medicines given. However, we saw several examples when staff had forgotten to go back and give people their medicines once they had woken so it meant that some important medicines had been missed. The manager said that a new handover sheet had been developed that may help staff remember to give these medicines and we also gave some advice on how to make improvements. We also discussed how the key code used to explain why medicines have not been given could be used better. Regular recorded checks of the medicines stock and records were carried out and when mistakes were found we saw suitable action taken to help prevent them happening again. All staff had recently attended further medicines handling training and all had been observed by the managers when giving out medicines to make sure they were doing it properly. Records of the medicines training, competency assessment and medicines audits were detailed and these were repeated regularly to help make sure staff have the necessary skills to handle medicines safely. We looked at a sample of care plans and records to check if medicines were properly reflected in them. We saw no formal system for recording information about how when required medicines were to be given. One person was taking a when required medicine for anxiety and another for pain but there was no clear information about how and when they should be given. Having clear written care plans helps make sure people get their medicines when they need them. Care Homes for Older People Page 4 of 9 We checked how controlled drugs (medicines that can be misused) were handled. A suitable cupboard was used for storage but this was not properly attached to the wall so it was not fully secure. A special register was used for record keeping and this was usually completed correctly. Having good arrangements for the handling of controlled drugs helps prevent them being mishandled and misused. We looked at how medicines were stored and found the majority of medicines were kept safe. However, some of the cupboards needed updating as they were not all fit for purpose. The manager said they had planned to improve some of the cupboards and this was to happen in the near the future. A suitable lockable fridge was used for medicines requiring cold storage but this was too warm when we checked it and had been for several weeks even though the temperature was regularly checked. Storing medicines at the wrong temperature can spoil them. We looked at how people were supported to look after their own medicines. We spoke with one person that was looking after one of their own inhalers. He told us he had been given the wrong inhaler this month as he was given a previously discontinued one. We also confirmed this by checking the records and speaking with the carer on duty. We checked the paperwork to support this and found it was not up to date and incomplete. A risk assessment and care plan had not been written to say how this person was to be supported. Having good care plans that are regularly reviewed helps make sure people receive the right amount of support to manage their medicines safely. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans and risk assessments should be reviewed and updated on a monthly basis or more frequently if needed ensuring information reflects the current and changing needs of people. 30/01/2009 2 9 13 Accurate records must be maintained with regards to the administration of medication so that errors do not occur and people are not placed at risk of harm. 19/12/2008 3 9 13 All medication must be administered as stated on the prescription ensuring the health and well being of people is not affected. 19/12/2008 4 19 23 A plan of work should be developed identifying redecoration and refurbishment required within the home along with timescales for completion so that people live in a comfortable well maintained environment. 30/01/2009 Care Homes for Older People Page 6 of 9 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 Medicines must be given to people correctly as prescribed. This will make sure their health and wellbeing is protected. 29/01/2009 2 9 13 Controlled drugs must be stored safely and according to the law. This wil help prevent mishandling and misuse. 23/03/2009 3 9 13 Medicines must be stored at the right temperature This will make sure medicines are not spoilt. 29/01/2009 4 9 13 A detailed risk assessment and care plan must be written for people that look after their own medicines. This will help make sure they receive the right amount of support to do it safely. 29/01/2009 Recommendations These recommendations are taken from the best practice described in the National Care Homes for Older People
Page 7 of 9 Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 9 Detailed information about how when required medicines should be used should form part of a persons care plan. Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
